Cervical cancer is an important cancer to American Indian women due to a high initial mortality and low 5-year survival rate compared to other ethnic/cultural groups. National data report that American Indians have the highest rate of cervical cancer incidence for any ethnic group studied. Because early cancer detection and follow-up has never been examined in this population, this study will evaluate the efficacy of the "Talking Circle," a culturally-appropriate psychosocial counseling intervention method, on the quality of life of American Indian women at risk for cervical cancer in Northern California. Promoting healthy behavior and increased treatment compliance through the Native American oral tradition of storytelling is an intervention approach acceptable in our Indian communities. Stories with a health concept using American Indian themes will be composed and will be used to transmit health messages regarding cancer prevention and screening/treatment, at the same time allowing women to interact in a supportive group setting. These stories will be culturally relevant, interesting and will help facilitate improved quality of life for Indian women at risk. California American Indian women over the age of 18, or sexually active, and at risk for cervical cancer are the target population. Two urban and four rural Indian clinics will be randomly assigned into intervention and control groups. Fifty women per rural clinic and 100 women per urban clinic (n=400) will be followed and evaluated on quality of life measures. Women aged 18-74 matched by years, attending targeted clinics, will be administered a self-administered pre- and post-test survey of cancer prevention knowledge, cancer screening behaviors, psychosocial measures and quality of life measures. Intervention clinic women will participate in a series of Talking Circle counseling sessions; control clinics will receive standard care. Clinic charts will be abstracted to provide data on screening behaviors. These data will be analyzed forming the evaluation of outcome measures. Process evaluation will also provide information on cultural adaptation of counseling and cancer screening programs.